Children's Home run by London Borough of Hillingdon in Hillingdon

Inspection report children’s home: SC068789 1 SC068789 Registered provider: London Borough of Hillingdon

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is owned and operated by the London Borough of Hillingdon. The service provides respite care for up to eight young people who have learning difficulties and physical disabilities. Up to four of the eight placements are used for medium-term placements for young people who are in crisis.

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected good

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: SC068789 2

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Key findings from this inspection

This children’s home is outstanding because

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Key findings from this inspection

 Young people who stay longer term in the home make outstanding progress from their starting points. This is a direct result of the care and support provided by staff.  Young people learn to make positive choices about the way they behave. This enables them to have a positive experience of care and significantly improves their attendance and engagement with education.  Staff listen to young people and review their care plans in the light of young people’s responses. Young people cooperate with staff and engage with the support offered to them.  Young people benefit from structured routines and engage in positive activities. This helps to keep them healthy and safe. They value positive relationships with staff and have a sense of belonging, both in the home and as part of the group.  The outcomes for young people are extremely positive. In many cases, young people are working towards family placements when this was not previously

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Key findings from this inspection

considered to be a realistic option for them. This is a direct result of the outstanding care provided by the home.  Young people enjoy respite care. Staff are thoughtful about matching them to stay with groups of young people that they get on well with. Staff know the young people well and provide excellent individualised care.  Feedback from parents and other professionals is overwhelmingly positive. They consistently describe how staff go ‘above and beyond’ in order to provide care and support to the young people and their families.  The manager of the home is an inspirational leader. She has a clear vision for the service and high expectations. Staff appreciate the support and direction that she provides.

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Key findings from this inspection

The children’s home’s areas for development

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Key findings from this inspection

 The provider’s written care plans for young people are not of a consistent standard. One care plan had not been updated recently and contained insufficient detail in terms of the interventions and support provided. This is an issue of recording rather than care practice.  The policies and procedures for the home do not describe the arrangements in place to manage health conditions that have potentially life-threatening consequences, such as epilepsy and allergies. In practice, staff are trained to meet these needs and contingency plans for medical emergencies are clear. This means that young people are safe.

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Recent inspection history

Inspection report children’s home: SC068789 3

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Inspection date Inspection type Inspection judgement

16/03/2017 Interim Sustained effectiveness 02/11/2016 Full Good 17/03/2016 Interim Improved effectiveness 29/10/2015 Full Good Inspection report children’s home: SC068789 4

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Recommendations

 Ensure that all local care and support plans describe how the service provides care which meets each child’s needs and promotes their welfare, taking into account their assessed needs, previous experiences and any relevant plans. (‘Guide to the children’s homes regulations including the quality standards’, page 14, paragraph 3.2)  The home’s policies for the protection of children should specify what arrangements are in place to manage risks relating to health needs such as epilepsy and allergies. (‘Guide to the children’s homes regulations including the quality standards’, page 44, paragraph 9.22)

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Overall experiences and progress of children and young people: outstanding

This service offers both respite care and longer-term placements for young people who have learning difficulties and physical disabilities. Accommodation is split over two floors and each group has a dedicated staff team. This minimises the potential for disruption for those who are living full-time at the home. This also ensures that the provider can allocate resources and manage the physical environment in order to safely meet the needs of each young person staying in the home.

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Overall experiences and progress of children and young people: outstanding

Outcomes for all of the young people staying longer term in the service are exceptional. They do better at school, and learn to improve their behaviour. They benefit from healthy routines and engage in constructive activities.

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Overall experiences and progress of children and young people: outstanding

The manager of the home is directly involved in the assessment and planning for all referrals and new admissions. She carefully considers the presenting behaviours and placement history of each child and pays close attention to the impact of new admissions on the existing group of residents. She has confidence in the ability of the staff team to help young people through crises and to manage challenging behaviours. This means that the provider is able to offer placements to young people who have had multiple placement breakdowns and present with complex care needs. One placing social worker described how staff responded with a high degree of professionalism and skill to plan an emergency admission from hospital of a young person in crisis. He reported that the young person was highly resistant to being accommodated in care. He described how staff were able to engage and support the young person to move in. The young person

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Overall experiences and progress of children and young people: outstanding

reported to the social worker the next day that he loved the home and ‘had the best morning of his life’. This young person presented significant challenges to the team, but quickly settled in and improved his behaviours and school attendance. The social worker believes that, as a result of the care and support provided by staff, the young person will be able to cope with living in a foster placement. This outcome was previously Inspection report children’s home: SC068789 5 considered by professionals to be unlikely.

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Overall experiences and progress of children and young people: outstanding

Another young person is now enjoying overnight stays with her family and plans to return to their full-time care. Her mother described how staff were able to help her daughter to manage her behaviours and talk through difficulties rather than act them out. She described how her daughter had ‘made a turning point’ and was doing well at school and enjoying home visits. A placing social worker for another young person praised the service. She said that the young person can now accept boundaries and has improved her behaviour. As a result of this improvement, it is far more likely that the young person can move into foster care.

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Overall experiences and progress of children and young people: outstanding

The progress and success enjoyed by all of the young people staying longer term has had a huge, positive impact on their future life chances. They are far less likely to suffer further placement breakdowns and much more likely to experience care in a family setting than was thought possible at the point of admission. Since the last full inspection in November 2016, all young people who have left the home have had planned, positive transitions and remain in stable placements that meet their needs.

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Overall experiences and progress of children and young people: outstanding

Young people were able to describe how things had improved for them. Two young people described how they ‘get into trouble less’. Another young person said that the home was ‘fabulous’ and she went on to describe how staff are helpful and caring.

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Overall experiences and progress of children and young people: outstanding

Attendance and progress in education are excellent for all young people. A representative from the placing authority’s virtual school praised the commitment and professionalism of staff. She described how they worked effectively with schools to implement behaviour management strategies. She felt that this had a positive impact on young people engaging with, and enjoying, education. She gave an example of how she felt staff went ‘above and beyond’ to ensure that a young person who was no longer placed at the home was able to enjoy a group excursion. She reported that one young person, who was on the verge of exclusion, is now more settled and making progress.

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Overall experiences and progress of children and young people: outstanding

Parents reinforced the message that staff frequently go ‘above and beyond’ to support young people and their families. One parent described how staff had provided respite for her son and stuck with him through extremely challenging behaviour. She commented that ‘I do not know what I would do without them’. She particularly valued the way that staff were always positive about her son and had a ‘glass half full’ attitude in the face of challenge. Another parent described how staff had stepped up and offered extra respite to support her and her son at a time of family crisis. She described the care that staff provide for her son as ‘brilliant’.

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Overall experiences and progress of children and young people: outstanding

Staff display genuine emotional warmth and care towards young people. They nurture and engage with young people in ways that are meaningful, thoughtful and helpful. They talk to young people and involve them in strategies to help them to make progress. This enables young people to respond positively and engage with support. They feel valued by the staff who are caring for them.

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Overall experiences and progress of children and young people: outstanding

The physical environment is of a high quality. It is well maintained, well presented and Inspection report children’s home: SC068789 6 has a bright, spacious, homely feel. There is a range of equipment for young people to play with and enjoy. The garden is a fantastic space for young people, with a range of outdoor play equipment for them to enjoy. Young people consistently report that the garden is something that they really like.

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How well children and young people are helped and protected: good

Young people are helped to stay safe as a result of the support and care that they receive in the home.

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How well children and young people are helped and protected: good

Each young person has an individualised care plan, which outlines their needs and the support that they require. Most care plans are of excellent quality. They describe in detail what each young person needs, how to care for them and keep them safe. One plan lacked sufficient detail in some areas and had not been recently updated. This creates the potential for staff who may be new, or do not know the young person well, to not have an accessible, effective care plan to refer to when providing care. It also removes a level of accountability in the event that staff vary from agreed approaches to care. In practice, staff know the young people well and young people experience safe and consistently high standards of care.

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How well children and young people are helped and protected: good

Individual risk assessments identify all risks and vulnerabilities for young people. There are clear safety plans to reduce these risks and to keep young people safe from harm.

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How well children and young people are helped and protected: good

Some young people have complex health needs and require expert support to keep them safe. Staff are trained and assessed to ensure that they have the skills and knowledge to provide this support. This training is regularly updated.

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How well children and young people are helped and protected: good

Some young people are diagnosed with epilepsy. When this condition requires staff to administer emergency medication, there is a clear protocol in place. This is written by health professionals and informs staff about what to look out for and what action to take in the event of an epileptic seizure occurring. For other young people who do not have prescribed emergency medications to manage epilepsy, protocols are not always in place. The home’s policies and procedures do not clearly set out arrangements to keep young people safe in these circumstances. This removes a level of information and accountability for staff in managing epilepsy safely. In practice, staff undergo specialist training to manage epilepsy and to administer emergency medications. In the absence of a protocol, staff immediately call an ambulance when a young person is having a seizure

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How well children and young people are helped and protected: good

In another example, the protocol agreed with healthcare professionals to protect a young person with a nut allergy was in the home, but not on the young person’s file. This was rectified during the inspection. The young person’s care plan and risk assessment outline what action staff should take to protect the young person with a nut allergy. Staff are trained in the use of epi pens and ensure that one is available at all times. Staff undergo training in the administration of medications. Young people receive the medications prescribed to keep them safe and parents comment positively that staff are vigilant and competent in this area. Inspection report children’s home: SC068789 7 The home is well resourced and there are always sufficient staff on duty to provide care and protection to the young people. Staffing levels are guided by detailed risk assessments and if young people need one-to-one support, this is provided. The staff

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How well children and young people are helped and protected: good

regularly review interventions and support. When risks decrease or behaviour improves, they reduce the level of staffing and supervision. This helps to ensure a good balance between keeping young people safe and promoting their independence. This is particularly helpful for young people who are preparing to move to family placements.

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How well children and young people are helped and protected: good

The exceptional progress in managing behaviours for the young people staying longer term is underpinned by excellent partnership working. Behaviour management strategies are informed by consultation with experts in child and adolescent mental health services (CAMHS). The provider works closely with the virtual school and education providers to implement education plans consistently. Strategies are regularly reviewed with the professional network, and staff pay close attention to their impact and effectiveness. This helps young people to experience consistent care that is both helpful and well informed.

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How well children and young people are helped and protected: good

Staff are resilient and patient when faced with challenging behaviour. Physical interventions are only used when this is necessary to protect young people from harm. All staff are trained to do this safely. They work alongside young people to learn from incidents. As a result, behaviour incidents and the use of physical interventions reduce over time for all young people.

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How well children and young people are helped and protected: good

Staff used a strengths-based approach and employ positive reinforcements to help young people learn how to manage their feelings. They involve young people in choosing rewards for positive behaviour and seek to ‘catch them being good’, rather than focus on negative or problem behaviours. This creates a safe environment, which enables young people to work through difficulties and talk about their worries.

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How well children and young people are helped and protected: good

Young people know how to complain and are encouraged to share their experiences with staff. When there are barriers to communication, staff work hard to ensure that they involve young people in making choices, and that they understand how young people are experiencing care in the home.

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How well children and young people are helped and protected: good

Young people get on well with each other. Staff are vigilant and skilful in the way that they support young people to be considerate of others and learn from the group living experience. Young people are able to reflect on the impact of their behaviours on others and apologise when things go wrong. There are no concerns about bullying and staff are often able to turn conflict situations into opportunities for learning. In one example, the inspector observed staff helping a young person understand that his attempts to make a joke were being perceived as teasing by another young person. This was done in a calm way that did not criticise him. He was able to apologise and adjust his behaviour.

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How well children and young people are helped and protected: good

Staff are trained in key areas of safeguarding, such as recognising risks relating to child sexual exploitation, radicalisation, and internet use. They know how to recognise signs that a young person may be at risk of harm and understand what action they should take to keep them safe. The provider works effectively in partnership with placing Inspection report children’s home: SC068789 8 authority social workers to address concerns. There have been no significant child protection concerns in the home since the last full inspection in November 2016. There are robust arrangements in place to ensure that young people are safe.

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How well children and young people are helped and protected: good

Each child has an individual plan to prevent them going missing from the home. The plan identifies clear actions for staff in the event that young people do abscond. In practice, young people do not go missing from the home.

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The effectiveness of leaders and managers: outstanding

The registered manager of the home is a qualified social worker and has extensive experience and training in the management of social care. This includes a level 5 qualification in the leadership and management of social care. She has a clear vision for the service, and high expectations in terms of the quality of care provided to young people and the outcomes they should aspire to. She is an inspirational leader who provides clear direction to staff about the standards expected of them, and takes robust action to ensure that high standards are maintained. She is supported effectively by an excellent deputy manager who has a strong sense of what matters to young people and is closely involved in the day-to-day running of the home. They listen to staff, they understand the challenges they face, and are genuinely concerned for their welfare. They are inclusive in their approach to managing the team and sensitive to the needs of

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The effectiveness of leaders and managers: outstanding

individual staff. They also lead and manage the team in a way that ensures that the primary focus remains firmly on the needs of young people.

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The effectiveness of leaders and managers: outstanding

Staff appreciate the support that they receive from managers. They have regular formal supervision and an annual appraisal. Staff performance is managed effectively and there are clear training and development plans in place for individuals and the team as a whole. The manager promotes a learning culture within the home and staff are able to reflect on their practice in an open, honest way. They acknowledge the challenges of the work and always seek to develop their practice. It is notable that staff take genuine pride in the young people’s achievements.

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The effectiveness of leaders and managers: outstanding

The registered manager demonstrates exceptional performance in a range of management tasks and skills. She is an expert practitioner, she directs and enables staff and she is an excellent administrator. She has excellent oversight of care practice in the home. She regularly monitors the quality of care provided to young people and takes effective remedial action in response to any identified shortfalls. For example, on noticing an increase in the use of physical interventions in the home, she evaluated why this was occurring and put effective measures in place to reduce incidents. She makes use of feedback from parents, social workers and young people to inform service development. The registered manager makes good use of feedback from the home’s independent visitor and addresses any recommendations promptly.

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The effectiveness of leaders and managers: outstanding

The registered manager is a strong advocate for the service within the wider department in the local authority. Her views are highly respected and she is able to secure the resources she needs to ensure that standards remain high and that the service can continue to improve. She advocates strongly for young people and her expertise and Inspection report children’s home: SC068789 9 leadership are valued within the professional network. This ensures that the first-hand experience of staff and young people informs care planning. Because of this, plans and interventions for young people are relevant, realistic and effective in producing positive outcomes.

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The effectiveness of leaders and managers: outstanding

The registered manager of the home has considerable experience of working with people who have learning and physical disabilities. She has undertaken specialist training to make assessments to ensure that their rights are protected when there may be limited capacity to make decisions. This means that she has expert knowledge to guide complex decision-making and practice in relation to protecting the rights of the young people who live in the home. Because of this, young people have an effective champion who keeps their best interests at the heart of decision-making.

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The effectiveness of leaders and managers: outstanding

The registered manager has clear plans to develop the service further. She has extended the core training of staff working with young people who stay longer term. This now includes specific training on the impact of trauma, abuse and neglect. She has strengthened the partnership with CAMHS and made arrangements for monthly reflective practice sessions led by a child psychologist. She has also commissioned accredited competency training for senior staff to improve their expertise in monitoring the administration and recording of medications.

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The effectiveness of leaders and managers: outstanding

The leadership team models excellent behaviour in promoting the rights of young people and ensuring equality of opportunity within the home. They closely scrutinise practice and make adjustments to ensure that young people can achieve their maximum potential.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC068789 10

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Children’s home details

Registered provider address: Civic Centre, High Street, Uxbridge Middlesex UB8 1UW

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Inspector

Lee Kirwin, social care inspector Inspection report children’s home: SC068789 11 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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